What Are the Levels of Lower-Extremity Amputations?

What does a lower-extremity amputation mean?

Lower-extremity amputation involves removing a part or parts of the lower limb.
Lower-extremity amputation involves removing a part or parts of the lower limb.

Lower-extremity amputation is the removal of a part/s of the lower limb. It is one of the oldest known surgeries. 

Humans in the stone age have been known to survive amputations arising out of injuries, rituals, and punishments. Cave-wall hand imprints showing the loss of fingers or toes have been also found. Unearthed mummies have been found buried with cosmetic replacements for amputated limbs.

With advancements in the field of medical science and technology, surgical amputations with the postoperative prosthesis are typically performed after all other options have been exhausted. The goal is to preserve as much of the limb and surgical reconstruction that maintains the most functionality. Amputation is done when the removal of the diseased limb becomes necessary to eliminate toxins from the body and save the patient’s life.

The number of amputations in the United States is expected to increase from 1.6 million in 2005 to 3.6 million in 2050. Whatever the reason for performing an amputation, it should not be viewed as a failure of treatment. Amputation can be the treatment of choice for a severe injury, vascular diseases (e.g., deep vein thrombosis or DVT) and tumors. 

Having an amputation should not be considered a path that leads to physical restriction or dependence.  After the removal of a diseased limb and the application of an appropriate prosthesis, the person can resume an independent lifestyle. 

A team of healthcare providers consisting of a surgeon, primary care physician, physical therapist, prosthetist, and counselor works with the patient. They teach the patient to lead an independent life by training them about how to walk with a prosthesis, apply and remove the prosthesis, care for the prosthesis, monitor the skin and the presence of any pressure points, walk on difficult terrain, and use the toilet at night.

What are the levels of lower-extremity amputations?

The various levels of lower-extremity amputations are as follows:

  • Foot, including toes or partial foot
  • Ankle disarticulation (at the ankle)
  • Transtibial (below the knee)
  • Knee disarticulation (at the knee)
  • Transfemoral (above the knee)
  • Hip disarticulation (at the hip)

Who needs a lower-extremity amputation?

Amputation may be performed for diseased limbs and devastating lower-extremity injuries for which attempts to save and reconstruct may be lengthy, and emotionally and financially costly with an unacceptable result. The indications are as follows:

  • Peripheral vascular disease (PVD): A blood circulation disorder that causes the blood vessels in the limbs to narrow, block or spasm, it is one of the leading indications for limb amputation in the United States.
  • Severe injuries (e.g., crush injury)
  • Tumors
  • Infections
  • Birth defects

What are the common complications of a lower extremity amputation?

The common complications of a lower extremity amputation include the following:

  • Wound breakdown and skin problems
  • Swelling
  • Infections
  • Joint contractures (a condition in which the joint becomes deformed and stiff leading to pain and loss of movement)
  • Pain
  • Phantom limb sensation (a sensation experienced by someone who has had a limb amputated that the limb is still there)

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References
"Lower-Extremity Amputations"

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